Camp Registration Form

Childs Name*

First NameLast Name

Birth Date*

MonthDayYear

Preferred Name

Were you referred to Camp LIFE by anyone? List who, if any.*

Select Camp shirt size

SmallLargeMediumExtra Large

Please provide any medical or dietary restrictions your child has.*

Parent/Guardian's Name

First NameLast Name

Contact Phone Number*

Format: (000) 000-0000.

E-mail Address*

example@example.com

How did you hear about Camp?

Emergency Contact Name*

First NameLast Name

Relationship to Camper*

Emergency Contact Phone Number*

Format: (000) 000-0000.

I, the undersigned, being the parent or legal guardian of the minor child identified above (hereinafter referred to as “Participant”), hereby grant full consent and authorization for the Participant’s involvement in Camp LIFE: The Great Exploration, a summer simulation-based youth program facilitated by Village of Women. I acknowledge and accept that the Program involves a range of experiential learning activities, including but not limited to: interactive workshops, career-based simulations, off-site excursions, and physical recreation. I understand that, while reasonable precautions will be taken for safety, participation may involve certain inherent risks. Accordingly, I voluntarily assume all such risks and agree, on behalf of myself and the Participant, to release, waive, discharge, and hold harmless Village of Women, along with its directors, officers, employees, volunteers, agents, and affiliates, from any and all liability, claims, causes of action, or demands of any kind, including but not limited to those arising out of injury, accident, illness, loss, or property damage, whether caused by negligence or otherwise, that may occur during or in connection with participation in Camp LIFE activities.

Furthermore, I expressly grant permission for the Participant to attend all off-site field trips or excursions organized under the scope of Camp LIFE. I understand that prior notice of such trips will be provided, and I agree to ensure the Participant is adequately prepared for participation.

I further acknowledge and accept that all Participants are required to adhere to the code of conduct and behavioral standards established by Village of Women and its representatives. I understand and agree that any violation of these standards, or behavior deemed unsafe or disruptive by camp leadership, may result in immediate dismissal from the Program at the sole discretion of Village of Women, without eligibility for refund. I understand and agree that all program fees are final and non-refundable, regardless of the Participant’s attendance, withdrawal for any reason, or removal due to conduct. By signing below, I affirm that I have read, understood, and voluntarily accept the terms and conditions outlined herein.

Signature*

I authorize Village of Women to photograph, film, or otherwise record my child during camp activities and to use these images for educational, promotional, or fundraising purposes across print and digital media. I understand that my child’s name will not be published without further consent, and that no compensation will be provided for the use of such materials. I waive the right to inspect or approve final media prior to publication.*

Yes, I give permission for photo/media useNo, I do not give permission

Camp Registration*

Camp LIFE (8-13 Years old) (9AM-4PM)

The Premier camp for life skills, social skills, and career exploration.

$180.00 Quantity

Morning Care (8AM-9AM)

Pricing is per day. Select the quantity based on how many days of service you require.

$5.00 Quantity

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Subtotal

$0.00

Tax

$0.00

Total

$0.00

Payment Methods

Credit Card

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Camp LIFE Registration Form

Family Information

Emergency Contact Information

Camp Waiver

Photo & Media Release

Payment Methods